Common patient data is key to VA, DOD project

The four partners will participate in the Government Computer-based Patient Record
(GCPR) project that VA and DOD began earlier in the winter. The team plans to release a
final statement of objectives this summer after receiving vendor comments, said Lt. Col.
Rosemary Nelson, deputy program manager for the Composite Health Care System II.


The group wants to move fast on the project and award a contract to build a GCPR
infrastructure as soon as Oct. 1. But the four partners have not decided on common tools
or bidders, Nelson said.


"We could use object-oriented, relational or virtual databases," she said.
Standard data elements will be necessary, however, so each patient in the system will have
comparable identification tags.


A common system would make the transition from active-duty service to veteran status
easier for soldiers and their dependents. Because DOD and VA have different systems, and
as many as 20 percent of DOD Health Affairs' records are on paper, the Veterans Health
Administration must recreate records for veterans instead of using DOD records, Nelson
said.


It would be premature to estimate how much money a GCPR approach would save, Nelson
said, because "we don't know the technology that will be deployed."


"We're putting out targets and not requirements," said Robert Kolodner, VHA's
associate chief information officer for business enterprise solutions and technologies.
"We're still in the process of defining parameters when we need to do something
difficult like worldwide deployment."


The central tools for the patient record system will have to follow common
communications, data, open systems and security standards, Nelson said.


"We won't have 50 pages of specifications," VHA CIO Dave Albinson said.
"We're giving broad guidelines, which include patient needs and compliance with
certain protocols and working across platforms."


To speed up the development process, the GCPR team will select a contractor from DOD's
Defense Medical Information Management/Systems Integration, Design, Development,
Operations and Maintenance Services II contract, Nelson said.


The Defense Supplies Services'Washington plans to select D/SIDDOMS II vendors this
year.


As long as the participants in the GCPR project have a common patient record, they can
design their own program applications, such as a note-taking system for nurses, Nelson
said.


The Defense Health Program will provide appropriations for DOD Health Affairs' share of
the project. Legislative funding and money from the three other partners should finance
the rest of the GCPR project, Nelson said, but the amount each partner will contribute is
undecided.


Some money will go toward setting up the common data elements and file structures for
record information such as name, address and marital status.


Health care organizations with proprietary systems will have to decide whether to
abandon them or make them "speak with the central tools through retrofitting,"
he said. "It won't be as cumbersome as it appears."


Defense's Health Affairs serves 8.4 million beneficiaries and runs 115 hospitals and
471 clinics with 147,000 employees in 13 regions. Veterans Affairs has 172 medical centers
that handle more than 28 million visits from veterans each year.

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